2015-06-15T08:58:11-05:00 2014-12-31 420946155 HONKAMP KRUEGER & CO PC P O BOX 699 DUBUQUE IA 520040699 990 2014-01-01 421412375 COTTAGE GROVE PLACE COTT 3193632420 2115 FIRST AVENUE SE CEDAR RAPIDS IA 52402 MARK BAILEY EXECUTIVE DIRECTOR 3193632420 2015-05-14 1 HEATHER D VETTER CPA P01355913 5635560123 2015-05-14 2014 2016-04-25 22:37:26Z MARK BAILEY 2115 FIRST AVENUE SE CEDAR RAPIDS IA 52402 12869459 0 X WWW.COTTAGEGROVEPLACE.COM X 1992 IA TO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A RETIREMENT FACILITY 18 18 241 3 0 0 0 0 13060667 12854359 2639 12097 0 0 13063306 12866456 0 0 0 0 5077197 5200747 0 0 0 5678662 5702111 10755859 10902858 2307447 1963598 28282440 30349777 43615305 43719045 -15332865 -13369268 TO PROVIDE HOUSING, HEALTH CARE, AND OTHER RELATED SERVICES TO RESIDENTS THROUGH THE OPERATION OF A RETIREMENT FACILITY 0 0 9112182 12854359 THE RETIREMENT FACILITIES CONTAIN 166 INDEPENDENT LIVING UNITS, 19 ASSISTED LIVING UNITS, 40 NURSING CARE BEDS, AND 12 SPECIAL CARE UNITS FOR ITS RESIDENTS. ABOUT 95% OF THESE UNITS WERE OCCUPIED AT YEAR END. 9112182 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 31 0 1 241 1 0 0 0 0 0 0 0 0 0 0 X 18 18 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X GREG OLBEKSON 3192975754 2115 FIRST AVENUE SE CEDAR RAPIDS IA 52402 DOUGLAS HEATH TRUSTEE 1.00 X 0 0 0 HAROLD G SCHAEFER TRUSTEE 1.00 X 0 0 0 RUSSELL H ANTHONY TRUSTEE 1.00 X 0 0 0 WILLIAM S ELLIOTT TRUSTEE 1.00 X 0 0 0 JOHN C WAGOR TRUSTEE 1.00 X 0 0 0 CARL E HALLBERG TRUSTEE 1.00 X 0 0 0 PHIL MORRIS TRUSTEE 1.00 X 0 0 0 KATHY TOBORG TRUSTEE 1.00 X 0 0 0 RALPH H PALMER TRUSTEE 1.00 X 0 0 0 TAD COOPER TRUSTEE 1.00 X 0 0 0 JAN ALTORFER TRUSTEE 1.00 X 0 0 0 ROBERT SILBER TRUSTEE 1.00 X 0 0 0 CRYSTAL USHER TRUSTEE 1.00 X 0 0 0 DON MOSIER TRUSTEE 1.00 X 0 0 0 DAVID BEY TREASURER 1.00 X 0 0 0 BILL JACOBSON CHAIRMAN 1.00 X 0 0 0 DICK HEFT SECRETARY 1.00 X 0 0 0 B D COOPER VICE CHAIRMAN 1.00 X 0 0 0 GREG OLBEKSON ACCOUNTING DIRECTOR 45.00 X 63929 0 0 63929 0 0 0 0 0 0 REHABCARE GROUP 680 SOUTH FOURTH STREET LOUISVILLE KY 40202 REHABILITATION 397854 HUNTER CONSTRUCTION CO P O BOX 1826 CEDAR RAPIDS IA 52406 CONSTRUCTION 294904 LIFE CARE SERVICES LLC 400 LOCUST STREET SUITE 820 DES MOINES IA 50309 MANAGEMENT 142389 3 RESIDENT SERVICES 623000 12854359 12854359 12854359 15100 15100 3003 -3003 -3003 -3003 12866456 12851356 0 15100 356902 356902 3861326 3100016 761310 32285 23974 8311 612279 556474 55805 337955 300592 37363 18800 18800 36225 36225 465014 156319 308695 169611 93566 76045 674978 643840 31138 31648 17705 13943 928022 928002 20 1143401 1109099 34302 253463 99000 154463 FOOD 646710 646710 MEDICAL EXPENSE 502033 502033 PROPERTY TAXES 287847 287847 DEPARTMENT SUPPLIES 135695 135695 408664 154408 254256 10902858 9112182 1790676 0 -3 1018843 1203864 166636 169068 51740 62268 141224 146488 38793846 15807499 22836295 22986347 4067702 5781745 28282440 30349777 893392 903666 10711536 11580714 21334310 20808385 10676067 10426280 43615305 43719045 X -15332865 -13369268 -15332865 -13369268 28282440 30349777 X 1963598 -1 X X 0 1 X 1 0 X 10443927 11099540 11860780 13058526 12854359 59317132 10443927 11099540 11860780 13058526 12854359 59317132 0 0 0 59317132 41427 29008 25600 4780 15100 115915 41427 29008 25600 4780 15100 115915 4758935 4758935 10485354 11128548 16645315 13063306 12869459 64191982 0.92410 0.92050 0.00180 0.00260 X 4016275 4016275 28756163 11783158 16973005 3226208 1656266 1569942 392998 295667 97331 2402202 2072408 329794 22986347 ASSETS LIMITED AS TO USE 4138453 DEFERRED FINANCING EXPENSES 830150 CONSTRUCTION IN PROGRESS 29237 BENEFICIAL INTEREST IN TRUST 295287 CASH VALUE OF LIFE INSURANCE 488618 5781745 REFUNDABLE ENTRANCE FEES 10245798 DEPOSITS 166455 CAPITAL LEASE 14027 10426280 X PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS RECOGNIZED COTTAGE GROVE PLACE AND COTTAGE GROVE PLACE FOUNDATION AS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE. MANAGEMENT HAS DETERMINED THAT THE CORPORATION DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AND ASSOCIATED UNRECOGNIZED BENEFITS THAT MATERIALLY IMPACT THE FINANCIAL STATEMENTS OR RELATED DISCLOSURES. SINCE TAX MATTERS ARE SUBJECT TO SOME DEGREE OF UNCERTAINTY, THERE CAN BE NO ASSURANCE THAT THE CORPORATION OR ITS SHAREHOLDERS WILL NOT BE SUBJECT TO ADDITIONAL TAX, PENALTIES, AND INTEREST AS A RESULT OF AN IRS EXAMINATION. GENERALLY, THE CORPORATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2011. FORM 990, PART VI, SECTION A, LINE 2 B D COOPER (VICE CHAIRMAN) IS THE FATHER OF TAD COOPER (TRUSTEE). FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT DUTIES FOR THE ORGANIZATION ARE HANDLED BY THE MANAGEMENT COMPANY - LIFE CARE SERVICES LLC. FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S FORM 990 IS REVIEWED BY THE BOARD AND THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO DISCLOSE EVERY YEAR POTENTIAL CONFLICTS WITH BUSINESSES THEY ARE ASSOCIATED WITH. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: INCREASE IN CASH SURRENDER VALUE OF LIFE INSURANCE -1. FORM 990, PART XI, LINE 2C THERE WERE NO CHANGES IN THE PROCEDURES FOR THE OVERSIGHT OF THE AUDIT.